Three GP practices have been put in to special measures after being rated as inadequate, the Care Quality Commission (CQC) has announced.

A spokesman for the CQC, England's independent health and social care regulator, said: "It is the first time and it is significant."

The special measures, which will come along with help and support from officials, are a six-month warning for improvements to be made. There could be a possible review of registration or, ultimately, a call for the practice to be shut down if improvements are not made.

Professor Nigel Sparrow, the CQC's senior national GP adviser, said: "Patients should be able to expect high quality and consistent care from every GP practice. Where we have required improvement, we will expect the practice to take the necessary steps to address the issue, and we will return at a later date to check that those improvements have been made.

"Three of the five practices which have been rated inadequate have been placed into special measures and have been offered a package of support by NHS England to help them improve. The other two practices have been told they will be put into special measures if they fail to improve."

The three practices which have been placed into special measures are Dr Srinivas Dharmana in Liverpool which inspectors rated as being inadequate for being safe, effective, caring, responsive and well-led.

The service provided by Dr Michael Florin in Sale, Trafford, was rated as inadequate for being safe and well-led. It was seen as being good at caring for patients but needs improvement to be considered responsive and effective.

The Priory Avenue Surgery in Caversham, Reading, was also rated as inadequate for being safe, effective and well-led. The CQC said it needed improvement to be considered caring and responsive.

The CQC named the two practices which have been told they will be put into special measures if they fail to improve as those run by Dr Sunil Srivastava, Richmond Medical Centre in Leeds, and the Widdrington Medical Practitioners in Widdrington, Northumberland.

The Leeds practice is inadequate for being safe, effective, responsive and well-led and needs improvement to be caring while the Northumberland GP was deemed as inadequate for being safe and well-led. It was rated as good at being caring, responsive and effective.

Patients who are with any of the practices that have been put into special measures were told not to worry and that they will not close down.

The help being provided by NHS England and the Royal College of GPs (RCGP) aims to ensure there are no immediate risks to patient safety.

NHS England's deputy medical director Dr Mike Bewick said: "General practice is the bedrock of the NHS and it's pleasing that the majority of practices inspected are rated good, with some rated outstanding.

"These inspections are about ensuring that every patient, anywhere across the country, receives consistently high quality services by identifying issues so improvements can be made. And for those in special measures that need extra support, we are working with the GPs, Local Medical Committees and CCGs (Clinical Commissioning Group) to help turn the affected practices around, including the offer of additional support from the RCGP."

Under the CQC's new inspections regime, all of England's GP practices are being rated according to whether they are safe, effective, caring, responsive and well-led.

The latest inspections have rated three practices as outstanding, 57 as good while 10 require improvement and five have been rated inadequate.

The Specialist Health Services (SHS) directors, who manage the Priory Avenue Surgery, accepted that they "still need to put further work into improving the running and organisation" of the practice.

They wanted "to reassure patients that patient care remains our top priority" and they would be "redoubling our efforts" to improve under the watchful eye of NHS England (South Central), the North and West Reading CCG and the Royal College of General Practitioners (RCGP).

In a statement they said: "We know that continuity of care is important to our patients and that improvements to our processes will help improve the running of the practice, so we ask that patients please continue to support us and please speak to us about any concerns they may have."

The SHS directors said they had taken over a practice with many challenges but counted patients being seen on the same day if needed, introducing legionella testing and reviewing infection control processes along with increasing the number of GP sessions available among the signs that it has made progress.

Trafford Clinical Commissioning Group, which provides support and advice to primary care in Trafford, said of Dr Florin's surgery: "Patients can be assured that the CCG is working with relevant agencies, including NHS England, to support the practice during the next six months and will ensure that the population of Sale receives locally delivered GP services which meet the required standard.

"In the meantime, patients of Norris Road Surgery can, during the period of special measures continue to receive their care at Norris Road Surgery in the same way."

The Royal College of General Practitioners (RCGP) chair Dr Maureen Baker said that struggling practices "need support, not criticism" and that is what the RCGP would aim to do.

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